Find a CMS Data File

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  1. Carrier RIF

    The Carrier file (also known as the Physician/Supplier Part B claims file) contains final action fee-for-service claims submitted on a CMS -1500 claim form. Most of the claims are from non-institutional providers, such as physicians, physician assistants, ...

  2. Durable Medical Equipment RIF

    The Durable Medical Equipment (DME) file contains final action, fee-for-service claims submitted by Durable Medical Equipment suppliers. This file includes: diagnosis, (ICD-9 diagnosis), services provided ( CMS Common Procedure Coding System ( HCPCS ) ...

  3. Home Health Agency RIF

    The Home Health Agency (HHA) file contains final action, fee-for-service claims submitted by HHA providers. This file includes: the number of visits, type of visit (skilled-nursing care, home health aides, physical therapy, speech therapy, occupational ...

  4. Hospice RIF

    The Hospice file contains final action claims submitted by Hospice providers. Once a beneficiary elects Hospice, all Hospice related claims will be found in this file, regardless if the beneficiary is in Medicare fee-for-service or in a Medicare managed ...

  5. Master Beneficiary Summary File

    The Master Beneficiary Summary File includes several segments. Base (A/B/D) segment : This segment includes beneficiary enrollment information, such as the beneficiary unique identifier, state and county codes, zipcode, date of birth, date of death, sex, ...

  6. Inpatient RIF

    The Inpatient file contains final action fee-for-service claims data submitted by inpatient hospital providers for reimbursement of facility costs. This file includes: diagnosis (ICD-9 diagnosis), procedure (ICD-9 procedure code), Medicare Severity ...

  7. Outpatient RIF

    The Outpatient file contains final action, fee-for-service claims data submitted by institutional outpatient providers. Examples of institutional outpatient providers include hospital outpatient departments, rural health clinics, renal dialysis facilities ...

  8. Skilled Nursing Facility RIF

    The Skilled Nursing Facility ( SNF ) file contains final action, fee-for-service, claims data submitted by SNF providers. This file includes: diagnosis (ICD-9 diagnosis), and procedure (ICD-9 procedure code), dates of service, reimbursement amount, SNF ...

  9. MedPAR RIF

    The MedPAR File contains inpatient hospital and skilled nursing facility ( SNF ) final action stay records. Each MedPAR record represents a stay in an inpatient hospital or SNF. Each MedPAR record may represent one claim or multiple claims, depending on ...

  10. Part D Drug Event File

    The PDE data contain prescription drug costs and payment data that enable CMS to make payments to the plans and otherwise administer the Part D benefit.  When a beneficiary fills a prescription under Medicare Part D, a prescription drug plan sponsor must ...

  11. MAX Personal Summary File

    The Personal Summary File contains one record for every individual enrolled for at least one day during the year. The file contains demographic data (e.g. date of birth, gender, race), basis of eligibility, maintenance assistance status, monthly ...

  12. MAX Other Therapy File

    The Other Therapy File contains claim records for a variety of Medicaid services, including physician services, lab/X-ray, clinic services, home health, hospice and premium payments.  Outpatient hospital institutional claims are also included in this file ...

  13. MAX Inpatient File

    The Inpatient File contains complete stay records for enrollees who used inpatient services including diagnoses, procedures, discharge status, length of stay, and payment amount. The MAX Inpatient File contains 10 diagnostic fields and 7 procedure fields. ...

  14. MAX Prescription Drug File

    The Prescription Drug File contains final action, paid drug claims.  Since 1996, the dispensed drug has been identified by an NDC . Drugs or supplies identified by HCPCS ( CMS Health Care Common Proceedure Codes) or any state-specific codes, are included ...

  15. MAX Long Term Care File

    The Long Term Care File contains claims for institutional long term care services provided by Nursing Facilities, Intermediate Care Facilities (ICFs), and independent psychiatric facilities. Fields include facility type, dates of service, and discharge ...

  16. Denominator RIF

    The Denominator File contains demographic and enrollment information about each Medicare beneficiary during a calendar year. The information in the Denominator File is 'frozen' in March of the following calendar year. This file is not available ...

  17. Part D Formulary File

    This is a CMS data file, available for request and use in analysis. Short Name:  Part D Formulary File Category:  Prescription Drugs Privacy Level:  Research Identifiable Files Program:  Medicare Qualified Entity Program File Version:  2010 Attachment ...

  18. Medicare-Medicaid Linked Enrollee Analytic Data Source

    The Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) has been developed to allow for the examination of all Medicare and Medicaid enrollment and claims data for those who were dually enrolled in both programs. The file includes records for ...

  19. National Health and Aging Trends Study (NHATS) - Medicare Linked Data

    The National Health and Aging Trends Study (NHATS) provides a resource for studying functioning in late life among the elderly population.  To assist in this effort, CMS administrative data can be linked to the NHATS files for researchers to provide more ...

  20. Inpatient Rehab Facility- Patient Assessment Instrument

    The Medicare Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) is used to gather data to determine the payment for each Medicare Part A fee-for-service patient admitted to an inpatient rehabilitation unit or hospital. IRF-PAI data ...

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